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2000 ; 15
(1
): 42-50
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Urinary bladder involvement in patients with systemic lupus erythematosus: with
review of the literature
#MMPMID10714091
Min JK
; Byun JY
; Lee SH
; Hong YS
; Park SH
; Cho CS
; Kim HY
Korean J Intern Med
2000[Jan]; 15
(1
): 42-50
PMID10714091
show ga
OBJECTIVES: To investigate the etiologies of urinary bladder involvement in
patients with systemic lupus erythematosus (SLE), the clinicoradiologic features
of gastrointestinal tract manifestations and clinical outcomes in patients with
lupus cystitis accompanied by gastrointestinal manifestations. METHODS: We
conducted a retrospective chart review on 413 patients with SLE. Patients were
selected for review on the basis of lower urinary tract symptoms including
urinary frequency, urgency and urinary incontinence. Radiologic studies were
analyzed in patients with lupus cystitis. RESULTS: Ten consecutive patients,
complicated with lower urinary tract symptoms, were identified. Underlying
etiologies were as follows: lupus cystitis in five, neurogenic dysfunction
secondary to transverse myelitis in three, cyclophosphamide-induced cystitis in
one and tuberculous cystitis in one patient. All patients with lupus cystitis
showed gastrointestinal manifestations, such as abdominal pain, nausea, vomiting
and/or diarrhea during the periods of cystitis symptoms. In all patients with
lupus cystitis, paralytic ileus was demonstrated on plain abdominal X-ray and
ascites, bilateral hydroureteronephrosis and thickened bladder wall were
identified on abdominal ultrasound or CT. Abdominal CT revealed bowel wall
thickening in four of the five patients. The main sites of thickened bowel on
abdominal CT were territory supplied by superior mesenteric artery. Two of five
patients with lupus cystitis expired during the follow-up period. CONCLUSION:
Diverse etiologies may cause lower urinary tract symptoms in patients with SLE.
Lupus cystitis is strongly associated with gastrointestinal involvement and
abdominal CT can be a useful radiologic tool to investigate the gastrointestinal
tract involvement in patients with lupus cystitis.
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